Sharing best practice: developing a Web-based database.

This article reports on the development of a web-based interactive database that was designed to facilitate the dissemination of practice development, research and audit projects across a large NHS trust. A multidisciplinary team worked collaboratively to design the database in order to ensure that it incorporated features which made it easy for the end user. Concise structured information on each project was recorded and search facilities incorporated to facilitate access to information. Hyperlinks to other web pages on the Internet and the Trust intranet were created and full reports/publications of projects were included for those who wanted more information. The subsequent implementation across the organization involved promoting the database, helping practitioners develop skills to access information, setting up quality review procedures for projects and evaluating its use. The development of the database has highlighted that time, the availability of computers in clinical areas and skills development are important considerations when taking forward information technology (IT) initiatives.

The immunogenicity of Haemophilus influenzae: meningococcal protein conjugate vaccine in Polynesian and non-Polynesian New Zealand infants.

OBJECTIVE: To examine the comparative immunogenicity of the Haemophilus influenzae type b-meningococcal protein (PRP-OMP) conjugate vaccine in Polynesian and non-Polynesian New Zealand infants. METHODOLOGY: Fifty-six Polynesian and 53 non-Polynesian infants aged 2-7 months recruited from primary health care settings in Auckland received a two-dose primary series of PRP-OMP. A sub-sample of 83 participants received a booster dose of PRP-OMP at 12-16 months of age. Anti-PRP antibody concentrations were measured in pre- and post-vaccination blood samples. RESULTS: Antibody responses consistent with long-term protection (> or = 1.00 microgram/mL) were observed in 72, 85 and 95% of children following the first, second and booster doses. CONCLUSIONS: Despite differences in disease epidemiology, PRP-OMP was highly immunogenic in Polynesian and non-Polynesian infants.

Oral health promotion for the older adult: implications for dental and dental hygiene practitioners.

The role of the dental and dental hygiene practitioner in geriatric oral health promotion can be viewed in terms of three questions. What purposeful or directed steps have been taken to improve oral health promotion? How can health promotion be improved? How can education and research help the practitioner? Professional associations, educators, researchers, school curricula, instructional programs, and dental products companies have tried to improve oral health promotion. At each level, communication of information and effective use of information has been compromised. Geriatric oral health promotion can be improved by increased understanding of: (1) health promotion concepts, (2) cultural and generational issues, (3) chronic oral conditions, (4) patients' perspective, (5) promoting behavior change, (6) listening skills, (7) patients' everyday realities, (8) integrating oral health issues into other health promotion activities, (9) creating easy to understand health education materials, and (10) lobbying for third party reimbursement for oral health promotion.

Dental needs and perceptions of adult Hispanic migrant farmworkers in Colorado.

To identify oral health needs, 231 adult Hispanic migrant farmworkers participated in an oral interview and dental epidemiologic survey in Colorado in summer 1986. DMFT and CPITN scores and restorative treatment needs were recorded. Overall treatment needs then were calculated. Mean DMFT was 9; 85% had one or more decayed teeth and 66% had one or fewer filled teeth. Analysis of CPITN scores revealed 69% displaying ADA perio cases types I and II, and 28% with ADA case types III and IV. Twenty-two percent of the sample had never received dental care, with another 56% not having received regular care. Barriers to care are cost, time factors, and perceptions of ineffective diagnosis or treatment. Differences by age, sex, language, education, home base, and care-seeking status are presented. Results document the need for increased preventive and treatment services and education for migrant adults.

Training dental and nondental professionals together: the oral health gerontology fellows program.

This project demonstrated the feasibility of training dental and nondental professionals to develop and implement programs in oral health care of older adults. Eight self-guided study modules were developed and tested. Trainees drawn from dentistry, dental hygiene, nursing, and planning/administration completed a 6-month individualized training program under the guidance of faculty mentors. Program structure, content, and implications are discussed.

Dental caries in permanent teeth in children of migrant farm workers.

A 1984 study of dental disease in 534 children (aged 6-15) of migrant farm workers in Colorado found that the prevalence of disease for this population continues to exceed the national and regional average. The mean DMFS was 3.56 with only 23 per cent caries free compared to a regional non-migrant DMFS mean of 2.50 with 44.7 per cent caries free. Results indicate that the children of migrant farm workers should remain a priority in preventive and restorative dental care programs.

Changing patient needs and their impact on clinical education.

Dental records of 1,800 clinic patients were examined in nine U.S. dental schools. The objective of the study was to identify what changes, if any, occurred over the five-year period between 1978 and 1982 in dental clinic patient treatment needs. Patients were found to be older at the time of entry into the clinical system and they required less operative treatment, fewer opposing full dentures, and less fixed bridgework. Increases in single full dentures and partial dentures were recorded. No changes were observed in endodontics, periodontics, or oral surgery treatment needs. These findings present a potentially serious problem in affected areas that may lead to a decline in the availability of sufficient experiences for the clinical training of dentists.

Characteristics of dental teaching patients.

Questionnaires were distributed to adult patients in a representative national sample of nine dental schools to solicit information on patient demographics, use of services, and perception of the care received. Responses from 2,346 patients were analyzed and compared to findings from various local studies. Results indicate: age range of patients and type of dental needs available to students is extremely variable among schools, the major referral system is through friends and relatives, most patients pay for all of their care and seek care at dental schools because of reasonable costs, transportation and parking pose significant problems for some patients, the majority of respondents had been patients for two years or less, and many patients want all of their clinical and interpersonal dental needs met in the school setting. Dental schools seriously need to consider such factors in light of current and projected teaching patient shortages.

Current and future projections of dental school patient availability.

Results of a mail questionnaire received from 59 United States and ten Canadian dental schools indicated a potentially serious problem in obtaining and maintaining dental teaching patients. Most schools report at least one shortage that could eventually compromise the clinical education process. Future projections indicated a continuing problem due to perceived reductions in disease incidence. The importance of addressing this problem is accentuated by the dental schools' educational mission to provide sufficient clinical experiences in all subject areas of dentistry. The information derived from the questionnaire should provide background for dental administrators as they respond to the patient availability problem.

Current availability of patients in dental hygiene programs.

Dental hygiene programs were surveyed to determine current availability of patients to meet the training needs of dental hygiene students. Eighty-six percent of the programs responded. Widespread inadequate to marginal patient availability was reported in periodontics and radiology. Two major reasons cited for patient shortages were, first, that completion of treatment requires too much time, and, second, that people are unaware of the scope of services performed by students. Patient shortages do not appear to be contributing to changes in the curriculum or fiscal problems in dental hygiene programs.